May 17th, 2012
By Jennifer Olin, BSN, RN
Right on the heels of National Nurses Week, the country’s nurse practitioners announced a new public awareness program. The American Academy of Nurse Practitioners (AANP) has set in motion a national campaign to increase public awareness of the critical role nurse practitioners (NPs) play in the American health care system.
Two years ago, President Obama signed the Affordable Care Act (ACA) health reform plan into law. As the provisions in the law start to take effect, millions of Americans are seeing noticeable differences in their health care. One change is that the healthcare law is expected to open up insurance coverage to as many as 32 million Americans over the next 10 years. Health policy experts anticipate that the wave of new insurance subscribers will lead to a spike in demand for medical services.
This is great news for the uninsured, but for an already overburdened healthcare system this could spell trouble. We’ve all heard there is a nursing shortage, but there is a physician shortage too. The Association of American Medical College predicts that the country will have 63,000 too few doctors as soon as 2015.
There is already a shortage of primary care providers in this country and that shortage is felt even stronger in our rural areas. Nurse practitioners just might be the answer.
“Four decades of research demonstrates that nurse practitioners provide high-quality, cost-effective, comprehensive, patient-centered health care with excellent outcomes,” says Penny Kaye Jensen, D.N.P., APRN, FNP-C, FAANP, and president of the AANP. “A fully enabled nurse practitioner workforce will increase access to quality health care; improve outcomes; and make the health care system more affordable for patients all across America.
“We are facing a health care crisis of unmatched proportions. With the number of physicians who provide primary care on the steep decline, AANP is launching this effort to educate Americans that nurse practitioners offer a viable, professional, and compassionate health care alternative. AANP is proud to take the lead in this effort,” Dr. Jensen added.
What Exactly Is a NP?
Nurse Practitioners are registered nurses with advanced degrees and clinical training who provide preventive and acute health care services. NPs take health histories and provide complete physical examinations; diagnose and treat many common acute and chronic problems; interpret laboratory results and X-rays; and can prescribe and manage medications and other therapies. NPs provide health teaching and supportive counseling with an emphasis on prevention of illness and health maintenance and refer patients to other health professionals as needed.
Nurse practitioners are already filling vacancies in many of this nation’s rural areas. Primary care providers of any kind are frequently scarce, and much of the rural U.S. has no primary care providers at all.
The first NPs were educated at the University of Colorado in 1965. As of 2012, there are about 155,000 NPs practicing in the U.S. with more than 11,000 new NPs prepared each year at over 355 colleges and universities. NPs have graduate, advanced education, and clinical training beyond their registered nurse preparation.
A nurse practitioner must hold a master's of science (MSN) in nursing or a higher degree. In addition, 89 percent are certified nationally in an area of specialty like acute care, family medicine, women’s health, pediatrics, or gerontology. All nurse practitioners must be licensed by their state nursing board.
In 16 states, NPs practice independently and are legally allowed to prescribe medications. Laws regarding nurse practitioners vary widely and in some states NPs are required to practice under the supervision of a physician, and must have a licensed physician to sign off on their work.
According to the AANP, nurse practitioners deliver “a unique blend of nursing and medical care, distinguishing themselves from other health care providers. In addition to being expert clinicians and diagnosticians, NPs provide comprehensive, personalized health education and counseling. NPs assist patients in making better lifestyle and health decisions.”
The Controversy Over Nurse Practitioners
However, for all their training and accessibility and public relations acumen, nurse practitioners and the AANP are likely to have a fight on their hands. An article in the Washington Post concerning the NP issue stated, “… doctors’ groups have often opposed such efforts of other professional societies to expand their medical authorities. The American Medical Association, which lobbies for doctors, often contends that such laws could put patients at risk.
“Non-physician professionals play vital roles in providing high-quality patient care, but no other health-care professionals’ education and training comes close to physicians’ more than 10 years of medical education and 16,000 hours of clinical experience,” AMA President Peter Carmel said.
Legislative analysts at the AMA say they’ve seen an uptick in state legislation meant to increase the powers of other professionals since the Affordable Care Act passed.” Legislators have introduced about 400 such bills just this year.
The AANP battle back, citing studies focused on patient outcomes. The AANP says that he safety and quality of nurse practitioner competency-based education has consistently been demonstrated through 40 years of patient care research.
Everyone knows that the educational preparation for physicians and nurse practitioners is different. However, according to the AANP, “although different, there is no evidence to suggest one is superior to the other in terms of patient outcomes, safety, and quality of care provided. There are numerous studies that demonstrate nurse practitioners consistently provided high quality and safe care. In the over 100 studies on care provided by both nurse practitioners and physicians, not a single study has found that nurse practitioners provide inferior services. In fact, these studies have shown NPs have the same or better patient outcomes when compared to physicians.”
As part of the promotional campaign, the AANP will also be undertaking a community-based grassroots education campaign. Members will routinely visit local community organizations, rotary clubs, church groups, community fairs, health expos and the like, where they will discuss local nurse practitioner resources and provide information about how patients can find a local NP as a primary care provider.
From a personal standpoint, I think NPs are great. I see several for my general healthcare needs and have never had a complaint. I think there is very much a place for this specialty in our healthcare environment.